What Causes Low Testosterone in Men?

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Low testosterone, also called male hypogonadism, has various causes. Some men are born with it while others develop it later in life due to injuries to testicles, chemotherapy, metabolic disorders, etc.

Treating the cause helps restore testosterone levels. Testosterone replacement therapy is the most commonly used treatment for low T in men.

Read on to learn common causes of low testosterone in men.

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What causes low testosterone in men?

1. Hypogonadism

The first medical condition that has been tied to low T and by far the most common is hypogonadism.

Hypogonadism refers to a condition in which the body is unable to produce enough testosterone to maintain healthy levels. This condition affects the centre of the testosterone production system called the hypothalamic-pituitary-testicular (HPT) axis.

Hypothalamus is categorized into two types; primary and secondary hypogonadism.

Primary hypogonadism is when testicles don’t produce enough testosterone while secondary hypogonadism is when pituitary gland or hypothalamus don’t send testicles the signals required to produce testosterone.

Causes of primary hypogonadism

Primary hypogonadism can be congenital or acquired. Its common causes are:

• Testicular injury
• Cancer treatment (chemotherapy and radiation therapy)
• Mumps infection
• Use of anabolic steroids
• Liver or kidney disease
• Normal aging
• Leydig cell hypoplasia
• Klinefelter syndrome
• Undescended testicles
• Hemochromatosis
• Noonan syndrome

Causes of secondary hypogonadism

The following health problems can cause secondary hypogonadism in men:

• Brain injury
• Hypopituitarism
• Hyperprolactinemia
• Hemochromatosis
• AIDS
• Kidney failure
• Liver damage
• Obstructive sleep apnea
• Obesity
• Kallmann syndrome
• Concurrent illness
• Inflammatory disease
• Certain medications

2. Cancer/disease treatments

Another potential medical condition that leads to low T is any strenuous treatment on the body for another condition such as prostate cancer and other disease treatments.

While cancer treatments are effective in treating cancer, they can have very heavy effects on the rest of the body. Those who are going through cancer treatments are known to have problems with testosterone levels.

If you are going through a treatment that is harsh on the body, then you might also experience low-T. Testosterone replacement therapy can sometimes be a solution for this, but usually, the only way to stop the effect is to cease the treatment, which is certainly almost never an option.

You should speak with your medical professional to inquire about possible paths forward to overcome this challenge.

3. Stress

When you are stressed and there is no good mechanism for dealing with stress, it can certainly affect your testosterone levels. The body doesn’t deal with large amounts of stress for prolonged periods of time very well, and when you are stressed about life events, it won’t take long to show.

If you believe that you have higher than normal levels of stress and you are experiencing low testosterone, then one of the first things that you should try is to manage stress via simple stress management exercises.

4. Lack of exercise or physical activity

While many people don’t realize it, the amount of exercise that you get can directly correlate to your level of testosterone.

Those who do moderate exercise and are in good physical condition will likely not have issues with testosterone production as a result of their physical fitness. However, those who do not get enough exercise are far more prone to low testosterone.

If you are in poor physical condition, one of the first things that you should do is get more exercise. This could very well unlock your potential when it comes to testosterone production and provide you with the healthy lifestyle that is recommended for those who want to have normal testosterone levels.

5. Diet

As you know, physical fitness has a lot to do with testosterone production. That includes not only exercise but also your diet.

In conjunction with getting more exercise and managing stress, a key part of the strategy is eating foods that are rich in vitamins and minerals and avoiding processed food as much as possible.

With improved eating habits and diet, you will be putting yourself in the best position possible when it comes to testosterone production and physical fitness.

6. Substance abuse

Alcohol, anabolic steroids and opioids all can directly impact your body’s ability to produce testosterone. They interfere with the hormonal signals required to start testosterone production and also damage Leydig cells that synthesize testosterone.

7. Hypothyroidism

Hypothyroidism means the inability of thyroid gland to produce enough thyroid hormones that control several bodily processes.

Low thyroid hormone can lower gonadotropin-releasing hormone (GnRH) production. And low GnRH means low luteinizing hormone (LH) synthesis.

LH signals testicles to form testosterone. When you have low LH levels, this means testicles are not getting enough signals required to produce testosterone, leading to testosterone deficiency.

 8. Age

Aging is one of the most common causes of low testosterone in males.

Testosterone levels decline as men get older. Many don’t experience any signs and live a normal healthy life. However, some aging males do experience low T signs like loss of muscle mass, low bone mineral density, erectile dysfunction, low sex drive, increased body fat, etc. and require a treatment.

What deficiency causes low T?

Men suffering from certain deficiencies are more likely to develop low testosterone. Common deficiencies that can contribute to low T are deficiencies of:

• Vitamin C
• Vitamin D
• Vitamin E
• Iron
• Zinc

That is why it is essential to have a balanced, healthy diet consisting of all the nutrients required for overall health.

Determining the cause of your low testosterone

The best way to determine which of the potential causes you are suffering from is to do a simple analysis of your physical condition.

If there are no glaring issues, then the cause is likely medical. Improve some lifestyle choices, you might see an improvement in the side effects.

If no amount of action on your part improves the condition, then it’s time to see a professional and enlist their help in pursuing the exact cause of your low testosterone.

Balance My Hormones can provide advanced blood tests for testosterone, get in touch if you would like to understand every aspect of your testosterone levels.

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What to do next about low testosterone levels?

If you are diagnosed with low T and know its cause, your doctor will likely treat the cause so they can help your body restart normal testosterone production.

For instance, if lifestyle factors like stress, obesity and poor diet are causing this issue, they may ask you to adopt healthy lifestyle habits.

In most cases, testosterone replacement therapy (TRT) is prescribed to restore normal testosterone levels within the body.

Testosterone replacement

Testosterone is a prescription-only medication that’s available in multiple forms, such as testosterone injections, gels and creams. These medications come in different doses to tackle different needs of people.

TRT can help teenage and adult males bring their low total testosterone levels within the normal range and improve their symptoms of low testosterone.

However, this hormone therapy should only be taken under the medical supervision as testosterone has potential side effects that need to be monitored throughout your testosterone treatment to ensure safety.

Also, men should not take it just to improve their athletic performance, despite having healthy T levels. It can hinder their body’s ability to produce natural testosterone and have other severe health effects like increased red blood cells count.

FAQs about causes of low testosterone

Can a varicocele cause low testosterone?

Yes, varicocele can cause low testosterone and sperm production in men. In fact, if it’s not treated on time and progresses to a high-grade form, the testicles can get permanently damaged, leading to low blood testosterone.

Does masturbation cause low testosterone?

No, masturbation does not produce low T. It may cause T level fluctuations temporarily but has no long-term effect on serum testosterone levels. Read our article on masturbation and testosterone to understand it more.

Can depression cause low T?

Yes, depression can reduce your free testosterone levels. Lack of sleep and high stress level associated with depression can interfere with hormonal balance and lead to low T. It’s interesting to note that low T can also lead to depression in some men.

Can high blood pressure cause low T?

Yes, various studies show that men with hypertension are more likely to develop low T compared to men with normal BP.

Summary

Low T has various medical and lifestyle causes. In order to treat this condition, it’s important to first diagnose its cause.

Lifestyle related causes of low T are generally treated with basic lifestyle modifications. However, many other causes require hormone replacement therapy like testosterone therapy.

TRT is an effective treatment that involves administering exogenous testosterone in the body to increase serum testosterone levels. It offers many health benefits but also has some potential side effects.

Discuss your TRT options with your healthcare provider to determine if it’s the right treatment plan for you.

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References

Monson, N.R., Klair, N., Patel, U., Saxena, A., Patel, D., Ayesha, I.E. and Nath, T.S., 2023. Association between Vitamin D deficiency and testosterone levels in adult males: a systematic review. Cureus, 15(9).

Wrzosek, M., Woźniak, J. and Włodarek, D., 2020. The causes of adverse changes of testosterone levels in men. Expert Review of Endocrinology & Metabolism, 15(5), pp.355-362.

Cohen, J., Nassau, D.E., Patel, P. and Ramasamy, R., 2020. Low testosterone in adolescents & young adults. Frontiers in endocrinology, 10, p.916.

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